Overall 41 cases of sexual abuse of minors were referred by the prosecuting authorities to the Psychiatric Assessment Clinic of the Papanikolaou Hospital from 2021 to September 2024.

From these complaints, only 22 involved sexual abuse by a person outside the family of the minor, according to the data presented by the Child-Adolescent Psychiatrist, Coordinating Director at the Child and Adolescent Psychiatry Department of the Papanikolaou Hospital Lilian Athanasopoulos, speaking at the conference “Sexual abuse of children: Is the current criminal law sufficient?”, organized by the Department Criminal and Criminology of Sciences of the School of Law of AUTH.

Ms. Athanasopoulou analyzed how it can be recognized that a child has suffered sexual abuse, but also its immediate and long-term effects on his life.

The main signs of sexual abuse of a child

The physical signs sexual abuse of a child include bruises, cuts, bites, injuries to the genital area, chest, buttocks or lower abdomen, itching, pain, unexplained genital bleeding, painful urination or frequent urinary tract infections, venereal disease in a young child , unexplained pain in the genital area, difficulty walking and seat, torn, stained or bloody underwear, teenage pregnancy and secrecy about the father’s identity.

On behavioral emotional cues include social withdrawal, introversion, psychological regression, sleep and appetite disturbances, depressive image, aggression and delinquent behavior, concentration disorders, decline in school performance, risky self-destructive behavior, lack of trust in familiar adults, fear of strangers or men , fear of the child being alone with a certain adult, running away from home, excessive preoccupation with sexual issues, age-inappropriate sexual behavior, excessive withdrawal, strong refusal of physical hygiene, excessive washing, emotional overstimulation.

“Each person experiences abuse differently and the consequences vary greatly from person to person,” while “sometimes a child victim of sexual abuse may not show symptoms of distress until they are older and to better understand the meaning of being sexually violated.”

More generally, in terms of symptoms in preschool age anxiety, restlessness, nightmares, age-inappropriate sexual behavior, in school age fear, aggression, nightmares, drop in school performance, hyperactivity, regressive behavior and in adolescence depression, withdrawal, self-injury , suicidal behavior, physical disturbances, delinquent acts, running away from home, substance use.

However, 1 in 3 abused children show no symptoms of abuse.

Ms. Athanasopoulou clarified that in the majority of cases there are no objective findings from the forensic expertise, while in cases of reports on very recent events the forensic examination should be carried out immediately without the slightest loss of valuable time.

He emphasized, however, that a negative forensic investigation in no way excludes sexual abuse of a minor, as to date there are no diagnostic test tools or laboratory, imaging or psychological tests that can demonstrate with certainty the history of violation or non-violation of a minor.

“About 1/3 of sexually abused children are symptom-free. Therefore, the child not having any symptoms does not tell us that he was not abused.

Risk factors associated with sexual abuse

Regarding the characteristics of the victims Ms. Athanopoulou stated that ¼ of the cases concern children under 5 years old, and more often young children with a peak age of 7-13 years.

Teenagers are at increased risk.

Most victims are girls, although boys are sexually abused at a ratio of 2.5:1. Victims tend to be weaker than the perpetrator. Children and adolescents with special needs are at increased risk.

The profile of the perpetrators

As far as the perpetrators are concerned, the evidence shows that 9 out of 10 cases of sexual abuse have male perpetratorss.

As far as the psychological profile of the perpetrators is concerned, this is a heterogeneous group in terms of personal, social and demographic characteristics. Two main aspects of their desire concern sexual pleasure and dominance, while pedophilia is a strong motivation.

It is also observed that perpetrators start their abusive activities in adolescence. The average age of juvenile offenders is 14 years.

Sta family characteristics a determining risk factor appears to be the absence of a supportive and protective relationship between the non-abusive parent and the child, as well as the absence of one or both parents, the presence of a stepfather in the home, parental disorders, parental substance use, poor marital relationship with severe conflict, punitive parenting, presence of abusive siblings, crowded home with financial difficulties where there is little to no private space.

However, the phenomenon of sexual violence seems to be less related to social pathogenesis than physical violence and neglect of minors.

The immediate and long-term effects of sexual abuse

Direct effects of sexual abuse include anxiety symptoms, acute stress disorder, depressive symptoms, sleep disturbances, phobic reactions, post-traumatic stress disorder, dissociative-type manifestations, growth retardation, eating disorders, decline in school performance, age-inappropriate sexualized behavior.

Long-term effects include anxiety disorders, post-traumatic stress disorder, low self-esteem as a fixed personality trait, borderline personality disorder, alcohol and substance use, affective disorders, unipolar depression, suicidal behavior, dissociative-dissociative-type disorders, eating disorders, sexual freedom, delinquency, difficulties in interpersonal relationships, health problems and increased predisposition to disease.

“The trauma of sexuality is not limited to sexual relationships. It defines our emotional autonomy as individuals and pervades our entire development. That is, it is connected to love with the concept of creation and the concept of life. Thus, very often we see children withered”, pointed out Ms. Athanasopoulou.

The importance of the interdisciplinary approach to the issue of sexual abuse of minors was underlined by Om. AUTH Law Professor Elisavet Symeonidou-Kastanidou that “it is very important in order to see mainly proposals for changing the legislative framework. “The Constitution recognizes minors as an independent good. It recognizes that the family must take care of the child’s development and therefore we, as representatives of the law, try to find the appropriate legislative framework to effectively protect children”, he said.